DESCRIPTION (Applicant's abstract): Increasing attention has been focused in recent years on the central role of drug therapy in preventing and treating illness in those over age 65. This has led to growing demands for data on the utilization, effectiveness, and outcomes of prescription medications in geriatric patients. Now that coverage of medication expenses for the elderly has become a central topic of debate at both the federal and local levels there is even greater for comprehensive, up-to-date data on the patterns of outcomes and costs of drug therapy for patients over 65, to inform the accelerating public debate. This application proposes the systematic construction of a multi-purpose database which will describe the economic, demographic, and clinical aspects of drug use in the elderly in one very large and generalizable population. The work will draw on the project team's experience in geriatric medicine, pharmaco-epidemiology, and health services research to build a resource that will be well positioned to inform future research and debate in this increasingly important area. The project will perform secondary analyses of previously collected data from the Medicaid and Pharmacy Assistance for the Aged and Disabled (PAAD) programs of the state of New Jersey, linked to the complete paid claims files of the Medicare program (Parts A and B) for all participants in that program living in the state of New Jersey. In their raw form, such claims data do not allow for any systematic investigation of patterns of use or clinical events. However, the modest level of support requested in the current application will make it possible to transform such data into a relational database that can be queried on many levels, and will be capable of addressing a number of important issues in geriatric drug use